I've worked with several hospitals on ratchet elimination. The key is having reliable curtailment capability that doesn't affect critical operations. Can they curtail things like parking lot lighting, some office areas, non-essential equipment during the few hours per year when curtailment is called?
Stormont Vail Hospital demand ratchet elimination
Arkansas hospitals have had good success with similar programs. The utilities usually only call curtailment 5-10 times per year, mostly hot summer afternoons. As long as you have backup power for critical systems and good load control, the risk is pretty manageable.
Stormont Vail Health in Topeka has 12-month demand ratchet with Evergy. Their peak was 8,940 kW last August during heat wave but normal demand is 6,500-7,200 kW. They're paying ratchet charges of about $4,200/month for that one peak day. Evergy offers a load management rate that eliminates ratchet but requires curtailment capability. Hospital has generators but they're hesitant about curtailment commitments.
They have pretty sophisticated controls and could probably curtail 500-800 kW of non-critical loads. The load management rate requires minimum 500 kW curtailment capability, so they'd qualify. Main concern is reliability - if they can't curtail when called, there are penalty charges.
Demand ratchet elimination through load management programs can provide substantial savings for hospitals with high seasonal peaks. The key is ensuring curtailment capabilities align with operational requirements and patient safety standards.